Determinants of Health Seeking Behaviours among Men With Lower Urinary Tract Symptoms Attending Surgical Out Patient Clinic at Meru Level Five Hospital

Abstract

Lower urinary tract symptoms (LUTS), describes a distinct phenotype of a group of disorders affecting bladder and prostate that share common clinical manifestations to include frequency, urgency, nocturia, difficult in initiating urination, sense of incomplete bladder emptying, decreased force of stream and interrupted stream. The main objective was to assess determinants of health seeking behaviors among men suffering from LUTS attending surgical outpatient clinic at Meru level five hospital. Analytical cross-sectional research design was adopted. The study population was male patients with LUTS attending Meru level five surgical outpatient clinic, physicians and nurses working at the clinic. The study tools used were questionnaires for quantitative data, key informant interview and focus group discussion guides for qualitative data. The quantitative data was analyzed using chi-square test and binary logistic regression. Qualitative data was analyzed thematically. The study revealed that 25.9% and 74.1% of the respondents had a high and low level of health seeking behavior respectively. Among the patient related factors associated with health seeking behaviors, the ones that were significant were: age of above 70 years 11.48 [95%CI = 2.59 – 50.86, P = 0.001], age of between 61- 70 years 0.26 [95%CI = 0.08– 0.86, P = 0.026] and age of between 51- 60 years were 0.07 [95%CI = 0.01– 0.63, P = 0.018]. Residing in urban areas 2.41 [95%CI = 1.11– 5.24, P = 0.026].Tertiary level of education 72.00 [95%CI = 5.70– 908.90, P = 0.001], secondary education 18.00 [95%CI = 1.50– 216.62, P = 0.023]. The socio-cultural factors that were significantly associated with health seeking behavior: being married 27.08 [95%CI = 5.99– 122.40, P <0.001],widowed 16.00 [95%CI = 1.42 – 180.90, P = 0.025].Religion (p=0.0432.39 [95%CI = 1.09– 5.27, P = 0.030].Family support 2.65 [95%CI = 1.04– 6.72, P = 0.040] ,and taboo on screening for LUTS 3.65 [95%CI = 1.61– 8.25, P = 0.002] and traditional treatment 2.40 [95%CI = 1.07– 5.40, P = 0.034]. On health institutional factors, adequate personnel 2.57 [95%CI = 1.09– 6.06, P = 0.032], adequate drugs were 3.14 [95%CI = 1.36– 7.23, P = 0.007], treated well by the health care workers 2.95 [95%CI = 1.18– 7.36, P = 0.021], short duration time taken to be served in the hospital were 2.40 [95%CI = 1.12– 5.16, P = 0.025] and distance to the health facility 2.21 [95%CI = 1.01– 4.84, P = 0.047],were significant parameters associated with health seeking behaviors.Therefore, there is need for sensitization for men on LUTS, home visits to encourage social/family support, continuous medical education to staffs and mobile clinic outreach to reach men with LUTS in the community.